Medicine · 2025
Choroidal metastasis as the first manifestation of renal pelvis carcinoma: A case report.
СтатьяКлинический случайНазвание и аннотация: Перевод в очереди
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Che Songtian, Li Ranwei, Wang Xu, Wang Guiyun, Cao Jinfeng
Аннотация
RATIONALE: Choroidal metastasis is an uncommon event, especially as the first sign of renal pelvis carcinoma (RPC), a rare subtype of upper tract urothelial carcinoma (UTUC). While the majority of choroidal metastases originate from primary cancers like breast or lung, those arising from urologic cancers are extremely rare. This article describes a case of RPC where the first clinical sign was a choroidal mass.
PATIENT CONCERNS: A 51-year-old female presented with a 2-week history of decreased vision in her left eye (OS). She reported no prior history of malignancy or significant family history of cancer. Examination revealed retinal detachment and a reddish-white, dome-shaped choroidal lesion. Multimodal imaging, including indocyanine green angiography, Doppler ultrasound, optical coherence tomography confirmed the metastatic nature of the mass.
DIAGNOSES: Magnetic resonance imaging, computed tomography and whole-body bone scintigraphy with 99mTc-MDP detected multiple metastases to the brain, lungs, and bone, with primary RPC in the left renal pelvis. These findings led to the diagnosis of metastatic RPC.
INTERVENTIONS: Given the advanced disease stage and poor prognosis, the patient declined invasive treatments such as biopsy or systemic chemotherapy.
OUTCOMES: Two weeks after diagnosis, the patient succumbed to rapid disease progression.
LESSONS: This is a unique case of RPC presenting with tetra-organ metastases involving the lung, bone, brain, and choroid. It underscores the need for a comprehensive systemic evaluation in patients with unexplained choroidal masses, as these may be indicative of an underlying, often asymptomatic, systemic malignancy. Further therapeutic studies are essential to explore effective management strategies and improve outcomes for similar patients with RPC.
PATIENT CONCERNS: A 51-year-old female presented with a 2-week history of decreased vision in her left eye (OS). She reported no prior history of malignancy or significant family history of cancer. Examination revealed retinal detachment and a reddish-white, dome-shaped choroidal lesion. Multimodal imaging, including indocyanine green angiography, Doppler ultrasound, optical coherence tomography confirmed the metastatic nature of the mass.
DIAGNOSES: Magnetic resonance imaging, computed tomography and whole-body bone scintigraphy with 99mTc-MDP detected multiple metastases to the brain, lungs, and bone, with primary RPC in the left renal pelvis. These findings led to the diagnosis of metastatic RPC.
INTERVENTIONS: Given the advanced disease stage and poor prognosis, the patient declined invasive treatments such as biopsy or systemic chemotherapy.
OUTCOMES: Two weeks after diagnosis, the patient succumbed to rapid disease progression.
LESSONS: This is a unique case of RPC presenting with tetra-organ metastases involving the lung, bone, brain, and choroid. It underscores the need for a comprehensive systemic evaluation in patients with unexplained choroidal masses, as these may be indicative of an underlying, often asymptomatic, systemic malignancy. Further therapeutic studies are essential to explore effective management strategies and improve outcomes for similar patients with RPC.